Individual
VINAY B GOWDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2701 N DECATUR RD, DECATUR, GA 30033-5918
(404) 501-5256
Mailing address
PO BOX 1457, BLUEFIELD, WV 24701-1457
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
59160
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
775076527A- EASTSIDE
—
GA
05
—
775076527B - DEKALB
—
GA
01
—
P00605278
RAILROAD MEDICARE - EASTSIDE
—
01
—
P00698646
RAILROAD MEDICARE-DEKALB
—
Enumeration date
03/14/2007
Last updated
09/22/2009
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